This form should be taken by the injured worker when he or she visits the doctor. The worker needs to fill out and sign the first part so that the doctor knows he or she has the worker’s permission to release important medical information to you. The doctor should fill out the rest of the form and sign it.
Occupational Fitness Assessment Form Template
Use this occupational fitness assessment form template to ensure the extent to which an employee can return to work after an illness.
This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.